Abstract 9471: Reverse Left Atrial Remodeling, Contraction and Compliance after Radiofrequency Catheter Ablation in Patients with Fixed Atrial Fibrillation
Background & Objectives: Restoration and maintenance of regular rhythm can be achieved by radiofrequency catheter ablation (RFCA) in patients with fixed atrial fibrillation (AF). However, it still remains undetermined whether this reversal is accompanied with amelioration of atrial function, which is associated with reduced risk of subsequent thromboembolic events.
Methods: We studied 35 consecutive patients (age: 63±10 years) who had received RFCA for fixed AF. Serial changes in left atrial (LA) size and function were evaluated with echocardiography at baseline, 2 weeks, 3 months and 12 months after the procedure.
Results: Thirty-one of 35 patients had recovered and maintained regular rhythm over 12 months following RFCA. Of these 31 patients, 7 patients required second or third sessions. LA size and biplane volume index significantly and progressively reduced over the time during 12-month follow-up periods (p<0.001 and p<0.001, respectively). Atrial contractibility, assessed by time-velocity integral of atrial wave and atrial filling fraction (p<0.001 and p<0.001, respectively), was improved after the procedure. In addition, atrial compliance, assessed by peak systolic strain of LA inferior and septal wall (p<0.001 and p<0.001, respectively), was also improved over the time. LA active contraction, assessed by LA late diastolic strain of LA inferior and septal wall, was appeared at 2 weeks after the procedure, and preserved during the follow-up periods. In addition, this improvement of atrial function was accompanied with that of left “ventricular” ejection fraction (p<0.001).
Conclusion: Restoration and maintenance of regular rhythm achieved by RFCA was associated with reduction in atrial size and volume as well as improvement in contraction and compliance. Our findings may encourage usefulness of RFCA for fixed AF, expecting risk of reduction of subsequent thlomboembolic events.
- © 2012 by American Heart Association, Inc.